Grand Rounds – best of medical blogosphere!

Hi friends.

Hope you all are living out a great fruitful holiday!

Check out Grand Rounds, a weekly compendium of the best posts in the medical blogosphere.

Every medical student should be blogging, says Nicholas Genes, MD PHD, ER resident in USA.

Enjoy and look forward to your posts!

Uncover Australia Photo Competition

hey guys. if you are free, why not check this out 🙂

since we’ve probably took quite a fair bit of photographs throughout the year. pick a nice one and submit then. who knows, you may catch the eyes of the judges.

technorati-ing this site

Technorati Profile

New online medical community: Tiromed

If you’re a physician, a medical student or a resident, then join Tiromed! You can search by groups, read articles created by the members, interviews, Member Spotlight, etc.

Come join this new online medical community !

Examples of articles for medical students:

N.B. You have to sign up first before you can take a look at the articles.

Surgery: Salaries, Jobs, and Prospects for Surgeons

General Surgery is a rigorous medical specialty that can overwhelm the unprepared. Because it is the ultimate option in curative therapy, surgical residents find their specialty to be among the most physical and psychologically demanding. Yet it is also one of the most gratifying and fulfilling paths a physician can take on the road to healing others. The route toward becoming a surgeon is lengthy and filled with a plethora of choices, from the initial decision to go into general surgery to choosing a residency program to opting for a subspecialty fellowship to establishing a career as a practicing surgeon. Each decision has far-reaching, life-changing implications.

Obstetrics & Gynecology: Jobs and salary information for ObGyn physicians

According to the 2000 U.S. Census, slightly more than half of the United States is female. Additionally, the country’s population is expected to increase by over 100,000,000 over the next 40 years. Based on these statistics, one can conclude that the specialty of Obstetrics and Gynecology is a field that will be in high demand for the long term. This fact, combined with the extremely rewarding nature of the specialty, makes OB/GYN an attractive option for new MD’s.

Resources for physicians / residents / fellows are numerous as well:

Finding Physician Jobs

Acquiring AIDS

Starting a practice: First steps and marketting strategies

I hope this preview of Tiromed has got you all excited and the only logical thing next for you would be to sign up!

Continuing Medical Education (holiday style!)

I spent the last 4 days in Hainan Island, China. Yes I’m Hainanese and I do speak the meagre basics of the dialect. I was there on a medical and social mission trip.

The attendance roll boasted 3 plastic surgeons, 2 anaesthetists, 1 dermatologist, 1 GP, 1 gastroenterologist and 1 MO. 3 medical students (2 from Monash – though I don’t know the other one) also joined in the medical ops in the village of Song Heng.

I initially helped out controlling the rowdy crowd outside the consulting rooms but soon I ‘upgraded’ to helping out in the makeshift operation theatre. You see, I have an interest in surgery so I was pleading and begging to get to help out there – for experience as well.

 We did just some minor surgeries but that’s where you start off right? – the small things first. So I scrubbed in for many lumpectomies, removal of sebaceous cysts. A reknowed plastic surgeon, an A/Prof to be exact, talked me through some of the procedures though he was reluctant to let me get involved.

I understood that it was because of public scrutiny of the operation and also my inexperience that was the reason. In missions, we have to serve wherever we can do best – and a medical student definitely can’t do his best in the OT.

But the tides of luck changed for me as another plastic surgeon allowed me to assist him in his operations. He too taught me plenty of interesting stuff.

 Best part – I got to do a surgery of MY OWN. Yes – flying solo. From incision to suture – everything. Though it was a small lipoma that I removed, I was ecstatic. Which holidaying first year medical student gets a chance like this. (Don’t worry, I did the job cleanly and well and the plastic surgeon looking over my shoulder)

What I Learnt:

1. Missions are good places for medical students to pick up experience.

2. You have to first love to serve before you can enjoy yourself like I did.

3. I will definitely sign up for the next big mission trip that comes my way!

Awakening Hippocrates: A Call for Health Providers to Serve Where Most Neede

Dr. Edward O’Neil, Jr., a practicing emergency physician at St. Elizabeth’s Medical Center in Boston and founder of Omni Med, voices his opinion on serving where is needed most.

What will you once you get that MBBS?

World AIDS Day

Yes that’s right! AIDS is the disease alot of us will inevitably see as practitioners one day.

Let’s revise abit of microbiology here. HIV (Human immunodeficiency virus) is a retrovirus with 2 serotypes – HIV1 & HIV2. It infects CD4+ cells of our immune system such as T lymphocytes and macrophages. This renders the immune system less effective and the body less protected against invading microbes.

A vaccine or cure has yet to be discovered. I’ve had conversations with some of our own friends who strongly oppose the development of this vaccine. Their ‘Christian’ views see it as a deserved punishment and that God introduced this disease into our species to punish us for sexual immorality.

What about those people who were born with HIV? What about the people who did not know their spouses had the disease? Think of the medical professionals that got the disease from other patients? How about the few blood transfusions that go through undetected?

My stand on finding a vaccine is clear: we must push all out to find a cure or a vaccine for this devastating killer virus. We are slowly running out of antiretroviral drugs used to prolong the life of those suffering from it.

As with polio myelitis, HIV, as the name suggests, only has a human reservoir. We can vaccinate and eradicate this disease from the face of this earth. Learning from previous mistakes, mankind should not be stupid enough to ‘create’ another sexually transmitted disease that kills one another. (HIV was mutated from the Simian Immunodeficiency Virus 1 initially infecting only certain primates)

Also, let us not look at those HIV+ fellow humans with disdain. They are not neccessarily sexually deviant or immoral. Even if so, we should not judge them because everybody makes mistakes. 

To you prudes who have not witnessed the real world for all the evil it yields; not everyone is brought up in as controlled and protected household as yours. As the world westernizes and sexual freedom is ‘promoted’ we must not assume Asian values to be superior. We are not! No one is actually superior. We are all comrades in the never ending war against those we can’t see and can’t beat – microbes. (And some of you feel like you’re in some spiritual battle – good for you.) 

We must not allow Asian stigmatization of sexually transmitted diseases to inhibit a very well westernizing society like ours. Enacted stigma of HIV+ individuals is on the rise; as medical professionals actively taking part in this stigma is disgraceful.

We do not advocate irresponsible sexual behaviour but we MUST NOT commit the err of allowing our values to marginalize any sufferers of AIDS. We MUST NOT shun the very people we will take an oath to help.

Join me comrades, this World AIDS Day, to spread the knowledge of safe sex and discourage the negative labelling of HIV+ friends. Peace out.

Singapore’s healthcare system moving in right direction: expert

Transpose: We suck, but we are getting there.

Singapore has scored a 4 to 5, out of 10 for its healthcare system and that is according to Professor Michael Porter, a Harvard expert on competitiveness.

Professor Porter, Competitiveness Expert, Harvard Business School, Advisor – Asia Competitiveness Institute, said: “The spirit is closer to the value model than most other economies. If you look at Germany or UK, you actually see them behind. They have some great doctors and some great institutions but philosophically Singapore is probably one of the most progressive countries in moving towards a value model. The US (has) a huge distance to go. US has high quality – the best in US is the best but the average is not good enough and we don’t get good value for 17 percent of GDP (spent on healthcare).”

But the score is lowered because Singaporeans don’t take charge of their own health enough – like going to the doctor to screen for diseases.

Professor Porter also says Singapore’s current healthcare system is still very much centred on hospitals – and more should be done to integrate outpatient services as has been done for diabetes.

Source: Yahoo! Singapore News

Will we get there?

i believe we will.

One of the first steps MOH is taking is to publish waiting times at polyclinics.

For those who want to know more about the Singapore Healthcare System, MOH provides a good overview.

Watson Waytt has done a review on us as well:

The Singapore health system – achieving positive health outcomes with low expenditure

That Prenatal Visit May Be Months Too Late

Public health officials are now encouraging women to make sure they are in optimal health well in advance of a pregnancy to reduce the risk of preventable birth defects and complications. They have recast the message to emphasize not only prenatal care, as they did in the past, but also what they are calling “preconception care.”

The problem, doctors say, is that by the first prenatal visit, a woman is usually 10 to 12 weeks pregnant. “If a birth defect is going to happen, it’s already happened,” said Dr. Peter S. Bernstein, a maternal fetal medicine specialist at Montefiore Medical Center in New York who helped write new government guidelines on preconception care.

That’s difficult isn’t it? To have a preconception visit? How would a married couple know when that intimate session have led to that successful sperm fertilising the ovum? And we are talking about married couples here.. what about the millions in the U.S. having loose sex?

Simple.

Doctors say that planning pregnancies and using reliable contraception are part and parcel of preconception care, and they are encouraging all health providers — not just obstetricians but emergency room doctors, primary care physicians, cardiologists and endocrinologists — to counsel women of childbearing age about the possibility of pregnancy. “What we’re actually talking about,” Dr. Atrash said, “is women’s health.”

Ob-gyn anyone, again?

Are you pro-life or pro-choice?

Abortion.

The touchy touchy topic.

Now what is abortion?

This post is prompted by a recent news report of increased no. of unsafe abortions performed in the U.S.

Balanced views on the net? This site seems to have it.

How is it done? One method is suction and curretage. Check the picture below:

obgyn anyone? this site offers some sane advice.

But then, there might be barriers, like these Florida medical students face.

The medical malpractice climate in Florida is discouraging medical students from pursuing careers in obstetrics and gynecology – a trend that could further reduce patients’ access to obstetric care, a survey by the University of South Florida College of Medicine found.

“Florida is already a state without enough obstetrician/gynecologists to meet the needs of patients. In some parts of the state, women must wait several months to see an obstetrician, and there are no perinatologists or maternal-fetal medicine specialists to take care of high-risk pregnancies,” Dr. Deutsch said. “Our findings suggest this shortage may get even worse.”